Search Results (203)

Objective: To evaluate the clinical significance of a flat oral glucose tolerance test (OGTT) pattern and its association with obstetric and perinatal outcomes, focusing on fetal growth. Methods: This retrospective cohort study was conducted at a tertiary referral center between January 2023 and November 2025. A total of 1198 women who underwent a two-step OGTT between 24 and 32 weeks of gestation were screened, and 685 eligible participants were included. A flat OGTT pattern was defined as fasting glucose < 95 mg/dL with all postprandial values < 100 mg/dL. The primary outcome was small-for-gestational-age (SGA); secondary outcomes included fetal growth restriction (FGR) and other obstetric outcomes. Logistic regression analyses were performed to assess independent associations. Results: Thirty-nine women (5.7%) exhibited a flat OGTT pattern. These pregnancies were characterized by a markedly attenuated postprandial glycemic response and lower fasting glucose levels. Most maternal and neonatal outcomes were similar between groups. However, SGA was significantly more frequent in the flat OGTT group (20.5% vs. 6.7%, p = 0.001). In multivariable analysis, a flat OGTT pattern remained independently associated with SGA (aOR 4.05, 95% CI 1.70–9.68, p = 0.002). Both SGA and FGR were more frequent among women with a flat OGTT pattern, although the association appeared stronger for SGA. Conclusions: A flat OGTT pattern appears to represent a distinct glycemic response characterized by an attenuated postprandial glucose response and lower fasting glucose levels. Although this pattern was not associated with a generalized increase in adverse obstetric or neonatal outcomes, it was associated with an increased risk of small-for-gestational-age infants. Full article

Rice starch (RS) is widely consumed, but is usually rapidly digested, which may increase postprandial blood glucose levels. Therefore, regulating RS digestibility is important for development functional starch-based foods. In this study, sodium alginate (NaAlg) was incorporated into RS gels and subsequently crosslinked with Ca²⁺ to form a calcium alginate (CaAlg) network, and its effects on the physicochemical properties, digestion behavior, and physiological responses of RS gels were evaluated. Rheological measurement showed that the Ca²⁺-crosslinked alginate network increased the viscosity and viscoelastic moduli of RS gels. Low-field nuclear magnetic resonance analysis showed that the Ca²⁺-crosslinked alginate network reduced free water mobility. Structural characterization using Fourier-transform infrared spectroscopy, X-ray diffraction, and cold-field scanning electron microscopy shows that the Ca²⁺-crosslinked alginate network was associated with enhanced intermolecular interactions and a more continuous gel network, while all gelatinized samples exhibited predominantly amorphous structures. In vitro digestion experiments showed that the hydrolysis degree at 120 min decreased from 92.3% in RS to 85.6% in HCaAlg/RS. The rapidly digestible starch content significantly decreased from 72.4% to 68.4% (p < 0.05), while resistant starch significantly increased from 7.7% to 14.4% (p < 0.05). First-order kinetic fitting showed that C_∞ significantly decreased from 93.0% to 86.0%, and k significantly decreased from 0.027 to 0.013 min⁻¹ (p < 0.05). In vivo experiments showed that the Ca²⁺-crosslinked alginate/RS gels were associated with a lower postprandial glycemic response, with the incremental area under the curve significantly decreased from 747.2 to 591.7 mmol·min/L (p < 0.05), and the intestinal propulsion rate decreased from 89.6% to 75.3% (p < 0.05). These results suggest that Ca²⁺-crosslinked alginate network formation may modulate the structural properties, digestion behavior, and digestion-related physiological responses of RS gels, providing a basis for the development of starch-based functional foods with improved glycemic control. Full article

Thai rice varieties, including Hom Pathum (Pathumthani fragrant rice) and Tubtim Chumphae rice, contain bioactive compounds with potential antioxidant properties. In this study, their acute effects on glycemic response, cardiac autonomic function, endurance performance, and oxidative stress were investigated in healthy adults. In a randomized crossover design, two independent cohorts of healthy adults were enrolled. A total of 50 participants completed two separate experiments (n = 25 per experiment), in which they consumed 140 g of control jelly, Hom Pathum rice jelly, and Tubtim Chumphae rice jelly in a randomized order on separate occasions. In Experiment 1, blood glucose (BG) was measured at baseline and every 30 min for 120 min, while insulin concentrations were assessed at baseline and after 120 min. In Experiment 2, participants performed treadmill exercise at 60% VO₂peak to volitional exhaustion, and exercise-induced oxidative stress was evaluated following exercise. Postprandial BG responses differed significantly among interventions. At 30 min, BG concentrations were lower following Hom Pathum and Tubtim Chumphae rice jellies compared with the control jelly (p < 0.001 and p = 0.002, respectively), and these reductions were maintained between 60 and 120 min, with Tubtim Chumphae rice generally demonstrating greater glycemic attenuation (p < 0.05). The BG area under the curve was significantly lower following both rice jellies than following the control jelly (p ≤ 0.005). No significant differences were observed in insulin concentrations, HOMA indices, heart rate variability, or blood pressure among interventions. Both rice jellies improved endurance performance compared with the control condition (p < 0.05), whereas post-exercise malondialdehyde concentrations were significantly reduced only following Tubtim Chumphae rice consumption (p = 0.049). These findings suggest that acute consumption of Thai rice-based jellies, particularly Tubtim Chumphae rice jelly, may attenuate postprandial glycemic responses and enhance endurance performance, with Tubtim Chumphae rice additionally demonstrating potential to reduce exercise-induced oxidative stress. However, these findings reflect short-term physiological responses in healthy adults and should be interpreted cautiously pending further mechanistic and long-term investigations. Full article

Cocoa-based foods are increasingly recognized as complex plant-derived matrices with potential relevance for metabolic health, driven by interactions among multiple bioactive components. Metabolic disorders, including insulin resistance and type 2 diabetes, are characterized by disturbances in glucose homeostasis, oxidative stress, and endothelial dysfunction. This narrative review critically examines the antidiabetic potential of cocoa-based plant matrices, integrating evidence from nutritional biochemistry and metabolic physiology. We analyze the specific role of cocoa flavanols in redox-sensitive signaling pathways related to nitric oxide bioavailability and insulin signaling. Furthermore, we evaluate how complementary matrix components, such as non-glycemic sweeteners, prebiotic and viscous fibers, oleic-rich lipids, and micronutrients, modulate postprandial glycemic responses, gut microbiota activity, and overall metabolic regulation. Current evidence indicates that the metabolic effects of cocoa cannot be attributed to isolated compounds but emerge from coordinated interactions within the food matrix. Understanding these multi-component dynamics is essential for the rational design of cocoa-based functional foods aimed at improving glycemic control and supporting metabolic resilience. Full article

In recent years, consumers have become increasingly aware of the health implications of diets high in sugar. This has prompted the baking industry to engage in the development of low-calorie biscuits while preserving the sensory and technological properties typically provided by sucrose. The present study evaluated the use of five polyols (erythritol, isomalt, maltitol, sorbitol, and xylitol), trehalose, and fructose (included because of its lower postprandial glycemic response compared with sucrose) as sucrose replacers in whole-wheat biscuits by assessing their physicochemical properties and sensory acceptability. The results demonstrated that the isomalt, maltitol and trehalose were able to preserve or improve the structural characteristics of the biscuits. Such an outcome was mainly associated with their ability to promote adequate dough spreadability and to produce biscuits with desirable crispness. Moreover, the biscuits formulated with isomalt and trehalose achieved the highest sensory appreciation, likely due to their high content of 2,4-decadienol, 2-acetatone and 2-pentanone, compounds associated with roasted and buttery flavour notes. Overall, the study demonstrated the feasibility of a complete replacement of sucrose in the production of reduced-calorie biscuits that could be highly acceptable by the consumers, utilizing polyols or low-digestibility sugar such as trehalose. Full article

Background: Effective postprandial glycemic regulation is essential for preventing metabolic disorders such as type 2 diabetes. While pharmacological interventions like GLP-1 (Glucagon-Like Peptide-1) receptor agonists are effective, dietary strategies using low-digestible carbohydrates (LDCs) may offer a sustainable and complementary approach. Methods: Two human physiological investigations were conducted to evaluate the acute metabolic responses to allulose, 1-kestose, resistant maltodextrin (RD), and fructo-oligosaccharide powder (FOP), administered both in isolation and in conjunction with a reference meal (RM). Results: In Study 1, all tested LDCs elicited minimal plasma glucose responses when consumed alone. In Study 2, distinct metabolic benefits were observed depending on the type of LDCs. Allulose exhibited the strongest effects, significantly reducing postprandial glucose and insulin levels while increasing plasma GLP-1 concentrations. 1-Kestose exhibited significantly lower plasma glucose and insulin incremental area under the curve (iAUC) compared to RM alone, indicating improved glycemic regulation. RD significantly enhanced subjective satiety between 30 and 180 min post-consumption. These findings highlight that each LDC exerts unique physiological effects. Conclusions: Collectively, these results demonstrate that acute LDCs consumption distinctly regulates metabolic responses, supporting their application as functional ingredients in targeted nutritional strategies for managing glycemic and metabolic health. Full article

Several lipid-management guidelines now favor non-fasting lipid measurements for cardiovascular risk assessment. In parallel, this review evaluated the potential clinical utility of non-fasting glucose measures, which may better reflect real-world glycemic responses, capture postprandial dysregulation not detected by fasting glucose, and offer greater practicality in routine clinical settings. Postprandial plasma glucose measured 4–7.9 h after a meal (PPG_4–7.9h) shows relative stability within this window and appears to be a promising marker for diagnosing diabetes and predicting mortality from cardiovascular disease (CVD) and cancer. Similarly, 2 h plasma glucose during an oral glucose tolerance test performed 4–7.9 h after a meal (2 h PG_OGTT4–7.9h) demonstrates diagnostic and prognostic value, particularly for diabetes and cardiovascular mortality. Notably, the diagnostic and predictive performance of these non-fasting measures is not inferior to that of traditional fasting glucose assessments. Mechanistically, postprandial hyperglycemia may contribute to CVD through increased oxidative stress and inflammation, endothelial dysfunction, and promotion of atherogenesis and thrombogenesis. It may also increase cancer risk via oxidative stress, inflammation, and insulin-mediated cellular proliferation. In addition, it may enhance lipogenesis to form membrane lipids supporting tumor growth. Further research is required to establish the clinical applicability, optimal thresholds, and generalizability of these non-fasting glucose measures. Full article

Aristotelia chilensis (maqui berry) is a Chilean native fruit rich in anthocyanins with potential antioxidant, glycemic, cardiometabolic, and ocular benefits, but its clinical efficacy remains unclear. This systematic review synthesized and critically appraised human trials evaluating oral maqui supplementation in adults. Following PRISMA 2020 and a PROSPERO-registered protocol, five databases were searched, and risk of bias and certainty of evidence were assessed using RoB 2/ROBINS-I and GRADE. Twelve clinical trials published between 2014 and 2023 were included. Acute studies consistently showed reduced postprandial glucose and modulation of insulin response, whereas chronic interventions showed modest and inconsistent effects on HbA1c, lipid profile, and other cardiometabolic markers. Favorable changes were also reported for oxidative stress biomarkers and autonomic parameters, although these findings were mainly based on surrogate endpoints. The most consistent evidence was observed in the ocular domain, where maqui supplementation improved tear production, dry eye symptoms, and tear inflammatory markers. The overall certainty of evidence ranged from moderate to very low because of methodological heterogeneity, small sample sizes, and short intervention duration. Maqui berry supplementation shows promise, particularly for acute glycemic control and ocular surface health, but larger long-term randomized trials using standardized formulations are needed before definitive clinical recommendations can be made. Full article

Refined wheat staple foods are widely criticized for low dietary fiber and high postprandial glycemic response, making soluble dietary fiber fortification a promising strategy for cereal improvement. This study investigated how resistant dextrin (RD) modulates wheat starch, gluten, dough, and bread quality through multiscale interactions. In wheat starch, 6% RD gave the best overall balance, reducing 14-day retrogradation from 57.2% to 48.6%, delaying gelatinization, and restricting amylose diffusion, with hydrogen bonding identified as a major contributing interaction. In gluten, RD increased water-holding capacity but weakened network integrity, as evidenced by reduced moduli, a shift in thiol–disulfide balance, secondary-structure redistribution (increased β-sheet, decreased α-helix/β-turn), and suppressed glutenin polymerization, yielding a looser microstructure. In dough, SEM and rheological results suggested that moderate RD (4–6%) may form a hydrated, polysaccharide-rich phase that fills structural voids and improves matrix continuity, partially offsetting gluten weakening and enhancing viscoelasticity. Overall, this study establishes a quantitative relationship between RD addition level, multiscale macromolecular interactions in wheat matrices, and the processing performance and quality of bakery products. Full article

Starch–polyphenol complexes have attracted increasing attention as functional ingredients for improving the structural stability and reducing the glycemic potential of starch-based foods, yet their application in extruded fresh noodles remains insufficiently understood. In this study, chestnut starch–resveratrol complexes prepared by heat-moisture synergistic recrystallization treatment (CS-HMRT-Res) were incorporated into extruded fresh noodles, and their quality, structural characteristics, digestibility, and glycemic response were systematically evaluated. Compared with commercial wheat-based Regan noodles, CS-HMRT-Res noodles exhibited enhanced cooking stability (lower swelling and leaching) and improved texture (hardness, chewiness, tensile strength), with a markedly lower total color difference after cooking (ΔE = 1.8 vs. 6.5). SEM, FTIR and XRD indicated a more compact and ordered network; the relative crystallinity of cooked noodles increased to approximately 30.8%. In in vitro digestion, CS-HMRT-Res showed the lowest starch hydrolysis extent at 180 min (45.92%) and yielded a low predicted glycemic index of 53.35, compared with 70.65 for Regan noodles. Consistently, gavage studies in mice confirmed that HMRT-Res-chestnut starch produced the lowest postprandial blood glucose increment response (4.31 mmol/L). Molecular dynamics simulations further suggested that resveratrol could competitively occupy the α-amylase binding cavity and reduce starch accessibility to the enzyme. Overall, CS-HMRT-Res improved processing quality, structural integrity, and reduced glycemic potential, offering a structure-function framework for designing low-GI products. Full article

Background/Objectives: Pigmented rice is increasingly recognized as a functional food because of its rich phytochemical composition and health-promoting potential. However, local red rice cultivars from the three southern border provinces of Thailand remain insufficiently characterized. This study comparatively evaluated four whole-grain red rice cultivars—Hawm Gra Dang Ngah 59 (HGDN 59), Hawm Mue Lau (HML), Lued Pla Lai (LPL), and Se Bu Kan Tang (SBKT)—for their chemical composition, antioxidant activities, and antidiabetic potential. Methods: Whole-grain rice samples were extracted with 95% ethanol and assessed for extraction yield, total phenolic content, and total flavonoid content. Antioxidant activity was measured using DPPH^•, FRAP, and anti-lipid peroxidation assays, while antidiabetic activity was measured using α-amylase and α-glucosidase inhibition assays. LC-MS/MS-based chemical profiling, pathway classification, PCA-based chemical space analysis, molecular docking against α-glucosidase, and physicochemical/ADMET prediction were also performed. Results: Among the tested cultivars, HGDN 59 showed the most favorable overall profile, with the highest phenolic content, strongest antioxidant activity, and marked α-glucosidase inhibitory activity. LC-MS/MS analysis combined with docking-based screening revealed that HGDN 59 contained several abundant compounds, including ent-Epicatechin-(4α→6)-ent-epicatechin, cinnamtannin A1, apiin, and α-tocotrienol. These compounds exhibited strong binding affinities toward α-glucosidase (−10.7 to −9.6 kcal/mol), comparable to or slightly more favorable than acarbose. ADMET prediction indicated that most polyphenolic compounds exceeded Lipinski’s rule of five, while α-tocotrienol demonstrated favorable absorption property. Conclusions: This is the first study to suggest that HGDN 59 exhibits potential α-glucosidase inhibitory activity in vitro and may serve as a promising functional food candidate for the dietary management of postprandial glycemic response. Full article

Background/Objectives: Soy flour has been proposed as a functional ingredient to improve the protein and fiber content of foods; however, its metabolic and sensory effects, particularly in individuals at elevated risk for metabolic disease, remain insufficiently characterized. This randomized, repeated-measures study examined whether substituting refined wheat or corn flour with soy flour influences postprandial glucose and insulin plasma concentrations, appetite ratings, and product acceptability in adults with overweight or obesity. Methods: Participants (N = 17) attended at least three separate visits during which they consumed, in random order, a food matrix with 0% (control), 10%, or 30% soy flour substitution. Food matrices included breads (n = 10), tortillas (n = 10), and arepas (n = 8); some participants completed more than one matrix. Postprandial plasma glucose and insulin concentrations were measured at baseline and at 15, 30, 60, 90, and 120 min post-ingestion. Subjective hunger, satiety, and product liking were assessed using a 10 cm visual analog scale. Results: Compared with the control condition, substituting 30% of refined flour with soy flour significantly reduced the area under the concentration–time curve for postprandial glucose for breads (p = 0.03) and arepas (p = 0.04), and reduced plasma glucose concentrations at 90–120 min for tortillas (p = 0.0009). In contrast, postprandial insulin concentrations and subjective hunger and satiety ratings did not differ across substitution levels or food matrices (all p > 0.05). Importantly, even 30% soy flour substitution maintained product liking. Conclusions: Incorporating up to 30% soy flour may improve postprandial glycemic responses without compromising overall liking, supporting its potential as a practical food reformulation strategy to improve metabolic health in populations at increased risk of metabolic disease. Full article

Background: Carbohydrate quality and culinary processing can meaningfully alter postprandial glycemia in people with type 1 diabetes (T1D). Cooling gelatinized starch promotes retrogradation and increases resistant starch (RS), potentially attenuating postprandial glucose excursions. Objectives: We investigated whether pasta cooled after cooking (24 h at 4 °C) and reheated before consumption improves postprandial glycemia in adults with T1D without increasing hypoglycemia risk under routine insulin pump bolus-calculator dosing. Methods: In this randomized, single-blind, crossover study, 32 adults with T1D treated with continuous subcutaneous insulin infusion (CSII) consumed two standardized pasta-based meals (50 g of available carbohydrate): freshly cooked pasta and cooled/reheated pasta. Participants administered rapid-acting insulin boluses calculated by their pump bolus calculator 10 min before the meal. Interstitial glucose was recorded for 180 min using flash glucose monitoring. Results: Compared with freshly cooked pasta, cooled/reheated pasta produced lower maximum glycemia (10.7 vs. 12.6 mmol/L, p = 0.0001), lower maximum glycemic rise (2.8 vs. 4.7 mmol/L, p < 0.0001), lower incremental area under the curve (iAUC; 211.9 vs. 524.8 mmol/L × 180 min, p < 0.0001), and a shorter time-to-peak (65 vs. 125 min, p = 0.014). Resistant starch content increased after cooling (12.88 ± 0.06 vs. 8.03 ± 0.08 g/100 g). The number of hypoglycemic episodes did not differ between conditions. Conclusions: Cooling and reheating pasta therefore increased RS and attenuated postprandial glycemia in adults with T1D without increasing early postprandial hypoglycemia in the studied setting. Full article

Background: Orange peels (OP) are rich in flavonoids, pectin, essential oils, and carotenoids that can be upcycled into functional ingredients. These bioactive compounds (BCs) have been increasingly associated with beneficial effects on gastrointestinal (GI) and cardiometabolic health. This scoping review aimed to systematically map available evidence and synthesize reported GI and cardiometabolic health outcomes of upcycled OP ingredients. Methods: Conducted in accordance with PRISMA-ScR guidelines, the literature search was performed in the Scopus database and ClinicalTrials.gov for studies published between 2014–2025 using a predefined Boolean search query. After screening, 84 studies and 14 completed clinical trials met the inclusion criteria. Results: The mapped evidence spans mechanistic (in vitro), preclinical, and clinical studies. Preclinical studies report that flavonoids, pectin, and essential oils modulate gut microbiota composition, enhance intestinal barrier integrity, and improve glycemic, lipid, and inflammatory parameters through mechanisms involving short-chain fatty acid production, antioxidant activity, and modulation of key inflammatory pathways. Clinical studies, predominantly investigating hesperidin-rich and fiber-rich extracts, report improvements in postprandial glycemic response, lipid profiles, blood pressure, and selected microbiota-related markers. Conclusions: Upcycled OP ingredients show promising biological activities relevant to cardiometabolic health and gut modulation, particularly in mechanistic and preclinical models. However, the evidence base remains largely dominated by in vitro and animal studies, with limited and heterogeneous clinical data. Key gaps include the underrepresentation of pectin and carotenoids in human trials and the absence of standardized, long-term intervention studies. Future research should prioritize well-designed clinical trials and investigate potential synergistic interactions among OP-derived bioactive fractions to support their translational application. Full article

Objectives: This study aimed to investigate the possible association among texture, oral processing and starch digestive characteristics of hard-cooked (HP) and soft-cooked (SP) potato samples, as well as their acute postprandial glycemic and insulinemic response, when co-ingested with rice in a meal. Methods: HP and SP replaced one-third of rice carbohydrates. Postprandial glycemic and insulinemic responses were measured after test meal ingestion. In vitro experiments evaluated sample physicochemical properties. Results: HP retained more resistant starch (RS) and total phenolics than SP. When co-ingested with rice (HP + R), HP elicited more total chews, higher oral sensory exposure time, slower chewing frequency and longer eating duration. HP + R significantly reduced postprandial glucose iAUC, peak glucose and glycemic excursion. SP + R increased glycemic variability despite reduced iAUCglucose. HP + R also lowered iAUCinsulin, peak insulin and insulin resistance index. The hypoglycemic effect did not extend to the second meal, though composite iAUCglucose over 540 min was reduced. Conclusions: Partially substituting rice with hard-cooked potatoes may help stabilize postprandial glycemic and insulinemic responses, an effect largely attributable to RS retention. Full article